The Sports and Pain clinic have several years experience using extracorporeal shock wave therapy machine to treat tendon pain. The clinic specialists use ultrasound to help diagnose tendinosis such as shoulder tendinosis, achilles tendinosis, plantar fasciitis, tennis elbow, golfers elbow and patella tendinosis. Treatments for tendinosis include managing muscle tenderness, treating the tendon using shockwave, muscle stretching and strengthening. Three sessions are required a week apart and it takes three weeks to see what effect this has made. If improvement has been seen then further sessions can be performed. Otherwise ultrasound guided sclerosing injections can be performed by the specialists at the clinic.

What is Shock Wave Therapy, and how does it work?

Shock Wave Therapy, also known as Extra Corporeal ShockWave Therapy (ECSWT), provides a treatment option to patients suffering from a range of chronic conditions such as plantar fasciitis and Achilles tendinopathy that are notoriously difficult to resolve. Shock wave treatment was originally developed to treat kidney and gall stones as an alternative to Lithotripsy treatment. Some patients who had their kidney stones successfully treated also reported improvement in chronic musculoskeletal conditions in regions which were in the pathway of the shockwave treatment. The problems with tendons is the basic healing process has failed and the high pressured acoustic shock waves that travel through the skin to breakdown poorly healed tissue including calcified tissue and stimulate tissue repair. Impressive results have been reported in cases that have been hard to manage and failed to respond to conventional treatment regimes and approaches. What sets this treatment apart from traditional treatments is that it treats the musculoskeletal pathology instead of just offering symptomatic relief. It is also the best last resort prior to ultrasound guided injections.

What conditions does Shock Wave Therapy treat?

Shockwave Therapy has attracted several clinical research trials which have supported its use in the treatment of patients with the following conditions:

Plantar Fasciitis/Heel spur (calcaneal spur)
Achilles tendinopathy
Rotator cuff tendinosis (Shoulder tendinosis)
Patella tendinopathy
Tennis elbow (lateral epicondylitis)
Golfers elbow (medial epicondylitis)

What does it involve?

The practitioner will deliver pulses of sound waves to areas of injured body tissue, via a hand-held probe placed on the skin. Some patients have described the shockwave process sounding like a small jackhammer. Depending on the area treated, you should expect to feel some small discomfort but this will resolve within 24 hours.

How many treatments will I need?

The therapy usually takes about three to six sessions of 5-10 minutes. ShockWave therapy is conducted at one weekly intervals. You may experience relief as soon as 10 days after the initial treatment.

What is the evidence?

There are a number of trials, including Randomized Controlled Trials, that support the use of Shock Wave
– Rompe et al 2008, Eccentric Loading Compared with Shock Wave treatment for Chronic Insertional Achilles Tendinopathy, J Bone Joint Surg Am 2008; 90: 52-61
– Han et al 2009, Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes, Foot and Ankle International, 30: 93-98
– Furia et al 2007, Extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis and Achilles tendinopathy, Current Opin Orthop 2007; 18: 101- 111
– Rompe, JD; Radial Shock Wave Therapy- Where do we stand today?; Translation from Medical Special, Apr 2006